Sogbossi Emmanuel Segnon, Houekpetodji Damienne, Kpadonou Toussaint G, Bleyenheuft Yannick
Motor Skill Learning and Intensive Neurorehabilitation lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.
School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
J Child Neurol. 2019 Nov;34(13):842-850. doi: 10.1177/0883073819864516. Epub 2019 Jul 24.
Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children's mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.
脑瘫是儿童运动残疾的常见原因。尽管高收入国家关于脑瘫儿童临床特征的数据越来越多，但低收入国家和发展中国家缺乏相应信息。因此，我们旨在描述贝宁（一个具有代表性的西非低收入国家）儿童脑瘫的临床谱。我们的横断面观察性研究纳入了从社区康复中心和教学医院招募的114名脑瘫儿童（中位年龄：7岁，范围2 - 17岁；性别：66%为男性）。通过查阅病历和与儿童母亲访谈收集数据。评估内容包括危险因素、根据欧洲脑瘫监测标准的临床亚型、由粗大运动功能分类系统（GMFCS）和手动能力分类系统评分的运动结局严重程度、合并症以及上学情况。我们记录到产时不良事件的高发生率。17%的儿童患有新生儿期后脑瘫，脑型疟疾是最常见原因。大多数儿童受到严重影响（67.5%为双侧痉挛型；54.4%为GMFCS IV级或V级），但严重程度随年龄大幅下降。只有23%的脑瘫儿童上学。运动结局差和合并症与未上学有关。这些结果表明，产时危险因素和婴儿期后脑型疟疾是撒哈拉以南低收入国家预防脑瘫的合适目标。
